TREATMENTS

Mr Horwitz deals with several common orthopaedic conditions in both children and adults, as you can see below.

Children:

  • Common paediatric hand and wrist trauma

  • Congenital hand surgery

  • The treatment of hands in people with cerebral palsy, brain and spinal cord injury

Adults:

  • Hand and upper limb trauma including: fractures and tendon injury

  • Arthritis of the hand and wrist including ganglion management

  • Sports injuries

  • Tendon injury and dysfunction (Triggering and De Quervains)

  • Nerve surgery (including carpal tunnel syndrome)

  • Dupuytrens surgery and injection



There is a large amount of information on the internet which is of variable quality. You should feel free to ask questions during your appointment but you may want to read about your condition or treatment. This page draws together some reliable sources of information available on the internet: surgical guidelines, information from specialist societies and patient resources provided by specialist surgeons and centres.

Hand & Wrist Information:

Support Groups - Paediatric & Congenital differences

Information about several hand conditions, provided by the British Society for Surgery to the Hand

Tendon disorders

Tendon disorders are medical conditions that result in the tendons not functioning normally.

Trigger finger/thumb - http://www.bssh.ac.uk/patients/conditions/18/trigger_fingerthumb

De Quervain's syndrome - http://www.bssh.ac.uk/patients/conditions/19/de_quervains_syndrome

Swellings

Swellings in the wrist and hand are very common. The vast majority are likely to be a ganglion which is a fluid filled cyst and utterly benign. Again a vast majority of ganglia will disappear spontaneously and do not require surgery. More firm lumps may require surgery as they are unlikely to resolve.

Ganglion cyst - http://www.bssh.ac.uk/patients/conditions/20/ganglion_cysts

Arthritis

The term arthritis is used to describe an inflamed joint but does not indicate the cause. There are many different types of 'arthritis' including osteoarthritis, rheumatoid arthritis and gout which can affect the hand. The commonest by far is osteoarthritis which may be familial or post-traumatic. In the hand the joints most affected are the base of the thumb and the terminal joint of the finger.

Terminal finger joint arthritis - http://www.bssh.ac.uk/patients/conditions/23/terminal_finger_joint_arthritis

Basal thumb arthritis - http://www.bssh.ac.uk/patients/conditions/24/basal_thumb_arthritis

Dupuytren's disease

Dupuytren's disease affects the hands and can produce contractures of the fingers which interfere with function. It is a benign disease which has no cure as yet. It can affect the hands in many different ways. You can find more information here.

Tendon injuries

Tendon injuries are the second most common injury seen in the hand. They are usually caused by a penetrating injury and if not repaired can result in severe functional loss. The tendons on the back of the hand are know as the extensors and those that bend the fingers are called the flexor tendons.

Flexor Tendon Injury - http://www.bssh.ac.uk/patients/conditions/18/trigger_fingerthumb

Extensor Tendon Injury - http://www.bssh.ac.uk/patients/conditions/19/de_quervains_syndrome

Mallet Finger Injury - http://www.bssh.ac.uk/patients/conditions/19/de_quervains_syndrome

Boutonniere Injury - http://www.bssh.ac.uk/patients/conditions/19/de_quervains_syndrome

Thumb extensor tendon (EPL) rupture - http://www.bssh.ac.uk/patients/conditions/19/de_quervains_syndrome

Hand fractures

Hand fractures are a common injury. The treatment is generally non-operative but there are certain types of fracture pattern that can only be managed by surgery. You can find more information here.

Hand joint injuries

Dislocations and sprains of finger or thumb joints can occur after a fall or whilst playing sport. Acute dislocations need to be reduced as soon as reasonably possilbe. Both injuries often result in stiffness which can take a long time to resolve.

Skiers thumb - http://www.bssh.ac.uk/patients/conditions/32/skiers_thumb

Finger sprains

What is a finger sprain ? A sprain refers to an injury to the tissues surrounding and supporting a joint. This includes the ligaments and joint capsule. You can find more information here.

Finger dislocations

What is a dislocation ? Dislocation of a joint means that the two surfaces are no longer in contact with each other. This can happen at any joint in the finger or thumb. You can find more information here.

Nerve injuries

Nerve injuries in the hand or wrist can result in loss of function and take a long time to recover. Early repair gives the best chance of recovery but depends upon the site of injury and its nature. You can find more information here.

Congenital Hand Conditions

You can find more information about congenital hand conditions here.

What is Hand Therapy

You can find more information about hand therapy here.